Long-term Clinical and Radiographic Outcomes After Salto Talaris Total Ankle Arthroplasty: Long-term Follow-up of a Previously Published Cohort.

Abstract

This study aimed to demonstrate long term clinical follow-up and implant survivorship of Salto Talaris-type primary total ankle arthroplasty (TAA) by 1 foot and ankle-trained surgeon at a single institution. Patients treated with primary Salto Talaris TAA were identified via <i>Current Procedural Terminology</i> (<i>CPT</i>) codes and included if they underwent primary TAA without history of arthrodesis and had complete imaging, clinical evaluation, and patient-reported outcomes preoperatively. Implant survivorship was calculated considering revision as requiring metal component explantation. Patient outcomes at final follow-up were compared to available preoperative values via paired <i>t</i> tests. <i>P</i> <.05 was considered significant. A total of 154 patients met inclusion (55.8% female, mean age at surgery 63.3 ± 8.9 years). Mean follow-up was 9.7 years (range, 0.6-17.6 years). Estimated implant survival probability was 100% at 1 year, 97.2% at 3 years (95% CI 94.6-99.9), 94.9% at 5 years (95% CI 91.3-98.7), 91.6% at 10 years (95% CI 86.7-96.9), and 86.9% at both 12 and 15 years (95% CI 79.3-95.3); no component explantation events occurred between 12 and 15 years, with the final explantation recorded at 15.28 years postoperatively. Thirteen patients underwent revision. There was no significant change in dorsiflexion but a reduction in plantarflexion (Δ = -4.3°, 95% CI -6.0 to -2.6; <i>P</i> < .001) at final follow-up. No significant changes were observed comparing radiographs at 6-week and final follow-up, including tibial component coronal alignment, posterior tibial slope, and talar component position. Among 87 patients (91 TAA) with complete long-term data, VAS pain decreased (Δ = -26.5, 95% CI -33.0 to -20.0; <i>P</i> < .001), mean FCS 12 increased (Δ = +20.9, 95% CI 18.7-23.2; <i>P</i> < .001), and MCS increased (Δ = +5.2, 95% CI 2.9-7.5; <i>P</i> < .001). All FAOS subscales improved significantly (<i>P</i> < .001). This cohort suggests that Salto Talaris-type TAA is associated with durable survivorship and patient outcomes at long-term follow-up in this single-surgeon series.